1. Field of the Invention
The present invention is related generally to the field of orthodontics. More particularly, the present invention is related to methods and systems for dispensing a series of orthodontic appliances in a sequence to a patient.
Repositioning teeth for aesthetic or other reasons is accomplished conventionally by wearing what are commonly referred to as “braces.” Braces comprise a variety of appliances such as brackets, archwires, ligatures, and O-rings. Attaching the appliances to a patient's teeth is a tedious and time consuming enterprise requiring many meetings with the treating orthodontist. Consequently, conventional orthodontic treatment limits an orthodontist's patient capacity and makes orthodontic treatment quite expensive. Moreover, from the patient's perspective, the use of braces is unsightly, uncomfortable, presents a risk of infection, and makes brushing, flossing, and other dental hygiene procedures difficult.
As a result, alternative methods and systems for repositioning teeth have been developed. For example, repositioning may be accomplished with a system comprising a series of appliances configured to receive the teeth in a cavity and incrementally reposition individual teeth in a series of at least three successive steps. Most often, the methods and systems reposition teeth in from ten to twenty-five successive steps, although complex cases involving many of the patient's teeth may take forty or more steps. The individual appliances are typically comprised of a polymeric shell having the teeth-receiving cavity formed therein, typically by molding. The successive use of a number of such appliances permits each appliance to be configured to move individual teeth in small increments.
Typically the systems are planned and all individual appliances are fabricated at the outset of treatment. Thus, the appliances may be provided to the patient as a single package or system. The order in which the appliances are to be used can be marked by sequential numbering directly on the appliances or on tags, pouches or other items which are affixed to or which enclose each appliance so that the patient can place the appliances over his or her teeth in an order and at a frequency prescribed by the orthodontist or other treating professional. Successive appliances will be replaced when the teeth either approach (within a preselected tolerance) or have reached the target end arrangement for that stage of treatment, typically being replaced at an interval in the range from 2 days to 20 days, usually at an interval in the range from 5 days to 10 days.
In general, it is preferable to simplify procedures for the patient to increase patient compliance and reduce patient errors in carrying out the treatment protocol. Therefore, it is desirable to utilize a packaging or ordering system which will provide appliances to a patient in a manner which is clearly discernable to the patient the order of the appliances. In addition, such packaging or ordering system should be amenable to mid-treatment changes to the treatment protocol, possibly adding or eliminating appliances after the initial set of appliances has been produced and packaged. At least some of these objectives will be met by the methods and systems of the present invention described hereinafter.
2. Description of the Background Art
Tooth positioners for finishing orthodontic treatment are described by Kesling in the Am. J. Orthod. Oral. Surg. 31:297-304 (1945) and 32:285-293 (1946). The use of silicone positioners for the comprehensive orthodontic realignment of a patient's teeth is described in Warunek et al. (1989) J. Clin. Orthod. 23:694-700. Clear plastic retainers for finishing and maintaining tooth positions are commercially available from RAINTREE ESSIX, INC., New Orleans, La. 70125, and TRU-TAIN PLASTICS, Rochester, Minn. 55902. The manufacture of orthodontic positioners is described in U.S. Pat. Nos. 5,186,623; 5,059,118; 5,055,039; 5,035,613; 4,856,991; 4,798,534; and 4,755,139.
Other publications describing the fabrication and use of dental positioners include Kleemann and Janssen (1996) J. Clin. Orthodon. 30:673-680; Cureton (1996) J. Clin. Orthodon. 30:390-395; Chiappone (1980) J. Clin. Orthodon. 14:121-133; Shilliday (1971) Am. J. Orthodontics 59:596-599; Wells (1970) Am. J. Orthodontics 58:351-366; and Cottingham (1969) Am. J. Orthodontics 55:23-31.